Hearing Loss

What is Hearing Loss?

Hearing loss refers to reduced hearing that results from a problem in one or more parts of the ear, and can affect people of all ages. Sound waves usually move through the external ear canal and vibrate the eardrum. The vibration of the eardrum is then passed on through the middle ear bones onto the cochlea (the hearing organ). The sensory cells of the cochlea are then stimulated and transmit signals to the auditory nerves (hearing nerves) and to the brain. The brain recognises these transmitted signals as sounds.

There are three types of hearing loss:

Conductive hearing loss - occurs when sound waves are not transmitted properly from the outside environment to the cochlea
Presbycusis - is the hearing loss that occurs with ageing
Sensorineural hearing loss - occurs when the cochlea or auditory nerves are damaged

1Causes

Causes

There are different causes that lead to obstructive hearing loss, and these commonly include:

Drugs, including certain antibiotics and cancer drugs, can damage some of the hearing nerves or the sensory cells of the cochlea, and therefore lead to otitis media (a group of inflammatory diseases of the middle ear).
Problems affecting the external ear canal, eardrum, middle ear bones, or middle ear space:
- Chronic diseases or trauma can cause the eardrum to burst, or the middle ear bones to be dislodged, damaged or fixed.
- Middle ear infection, also known as otitis media. Otitis media occurs due to a variety of causes including increasing age, inner ear viral and bacterial infections (mumps, measles, influenza), ménière disease (inner ear disorder that affects balance and hearing), and damage to the sensory cells in the cochlea due to acute or chronic exposure to loud noises.
- The external ear canal can become blocked by wax or foreign objects, or it can become infected.

2Symptoms

Symptoms

Hearing loss is characterised by sudden or gradual onset, and it can affect one or both ears. The symptoms of hearing loss include:

Difficulty understanding what other people are saying, especially against background noise
Earache and ear discharge due to ear infections
Frequently asking for directions or conversations to be repeated
Ringing in the ears (tinnitus)
Speaking louder than normal
Spinning sensations (vertigo)
Withdrawal from conversations

3Treatment

Treatment

The treatment of hearing loss depends on the underlying cause. Your doctor will evaluate your condition and suggest the treatment that suits you best:

If hearing loss is caused by ear wax build-up or a foreign body in the ear canal, your ENT surgeon can remove it under a microscope.
If hearing loss is caused by an external ear infection, you may be prescribed some topical antibiotics.
If hearing loss is caused by a burst eardrum, your treatment will target the underlying cause. Surgical repair may be necessary to fix a burst eardrum if it is not repaired within three months, or if you suffer from frequent ear infections and associated ear discharge.
If hearing loss is caused by certain medications, your doctor will prescribe different medications or ask you to stop taking them.
If hearing loss is caused by ageing (presbycusis), there is no cure. Your ENT specialist might recommend a hearing aid depending on your condition. Otherwise treatment will be aimed at protecting your hearing as much as possible to slow down further loss.